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Modern science has made great strides in the
prevention and treatment of heart disease; nevertheless, it is
still the number one killer in the United States, accounting for
about 600,000 deaths each year. A heart condition requires the
attention of a qualified physician and is not something to take
lightly or to attempt to self-diagnose or self-treat, but that
doesn’t mean that you can’t take steps to prevent the condition in
the first place. Herbs can play a role in reducing your risk of
heart disease when incorporated into a heart-smart health
regime.

Fat-laden arteries

One of the signs of aging is arteriosclerosis, a hardening of
the arteries with loss of elasticity and restriction of blood flow
through the body. One type of arteriosclerosis is atherosclerosis,
the buildup of fatty deposits on and in arterial walls and a
leading culprit in heart disease. Clogging of the coronary
arteries, the small arteries that supply the tissues of the heart
itself with oxygen and nutrients, can lead to chest pain (angina),
congestive heart ­failure (inability of the heart to maintain the
circulation of the blood through the body), and heart attack.

The fats that build up on artery walls are carried in the blood.
Blood fats, or lipids, include cholesterol (both “bad” LDL and
“good” HDL) and triglycerides. You can increase heart-protective
HDL by stopping smoking (a good idea in any case), losing weight,
and exercising. To lower total cholesterol, follow a diet low in
calories and total fats, especially saturated fats, and high in
whole grains, fruits, and vegetables.

Your physician can help you evaluate other heart-disease risk
factors such as heredity, age, gender, sedentary lifestyle, high
blood pressure, and stress. While there’s not much you can do about
the first three factors, eating right, exercising, and managing
stress are proven keys to a healthy heart. Furthermore, two herbs,
garlic and hawthorn, can play a significant role in reducing your
risk of atherosclerosis.

Two herbs, garlic and hawthorn, can play a significant
role in ­reducing your risk of atherosclerosisGarlicEating garlic (Allium sativum) lowers blood pressure and aids
blood flow through the circulatory system by reducing the amount of
fat in the blood and thinning it, which enables platelets (blood
cells that normally aid in clotting) to move more freely. The
sulfur compound allicin, the source of garlic’s familiar aroma, is
responsible for these effects. It is formed by the reaction of
alliin with the enzyme allinase when garlic is cut or bruised.

Between 1985 and 1995, twenty-eight controlled clinical studies
examined the effect of garlic preparations on healthy people as
well as those with high cholesterol, high blood pressure, coronary
artery disease, clogged arteries, and other conditions. Blood
fat-regulating ­effects, including decreases in total cholesterol,
LDL, and triglyceride levels, and increases in HDL, were recorded.
Taken together, the studies showed an average 10.3 percent decrease
in total cholesterol and a 14.3 percent decrease in triglycerides.
A dose of 600 to 900 mg of garlic powder containing 3.6 to 5.4 mg
of allicin was recommended to lower blood fats significantly. In eight of the studies, blood pressure decreased by an average
7 to 9 percent after one to six months of treatment. Persons with
marginally high blood pressure showed the greatest change; those
with normal blood pressure had no change.

Although thousands of studies have supported garlic’s
cardiovascular benefits, a recent small study conducted at the
University of Oxford that found no significant difference in
­cholesterol levels between the treatment and placebo groups
illustrates the need for standardizing testing conditions. The
researchers suggest further trials involving at least 1,000
participants to resolve the differences in study results.

In Germany, therapeutic use of garlic is allowed in the
treatment of elevated blood fats and to deter atherosclerosis.

Hawthorn

Extracts of the leaves and flowers of Crataegus laevigata, C.
monogyna, and other species of hawthorn are prescribed by
physicians in Germany and elsewhere to improve heart performance in
the early stages of congestive heart failure, angina pectoris,
age-related heart problems, and mild irregular heartbeat, as well
as during recovery from heart attacks. Pharmacological and clinical studies have shown that hawthorn
increases the blood supply to the heart muscle itself and
strengthens contractions. As the blood vessels dilate, the heart is
then able to pump more blood to the rest of the body.

Hawthorn was used clinically both in the United States and
Europe in the first half of this century for the treatment of heart
disease. Modern research on the herb began in the mid-1960s. From
1981 to 1996, fourteen controlled clinical studies were published
on the effectiveness of hawthorn extracts in more than 800
patients.

No single compound is believed responsible for hawthorn’s
beneficial effects on the heart. Among its constituents are
sterols, triterpenes, flavonoids, catechins, proanthocyanidins, and
amines, all of which have been shown to affect the cardiovascular
system. Commercial preparations, primarily those manufactured in
Europe, are standardized to contain flavonoids, oligomeric
procyanidins, and chlorogenic acid, among other constituents.
Timing of the harvest is important, as fall leaves may contain
three times the amount of procyanidins as spring leaves.

European physicians generally prescribe from 160 to 900 mg per
day of a water-and-­alcohol extract yielding 4 to 20 mg of
flavonoids and/or 30 to 160 mg of oligomeric procyanidins. Hawthorn
must be used for at least six weeks before results can be expected.
No side effects or contraindications have been reported.

Black Cohosh: For ease in menopause

Black cohosh, or black snakeroot (Cimicifuga
racemosa), a handsome perennial herb native to North America’s
eastern deciduous forests, has a long history as a Native American
remedy for gynecological disorders. Now, with its reputation
bolstered by modern scientific research, it is helping scores of
aging baby boomers cope with the discomforts of menopause. Its
robust foliage and tall spires of brilliant white flowers are well
known to gardeners, but it is the thick, knobby, resin-scented
roots that have caught the attention of scientists and drug
manufacturers.

The herb

This member of the buttercup family is found on moist hillsides
in rich woods from southern Ontario south to Georgia and west to
Arkansas. Its thrice-divided leaves with three-lobed terminal
leaflets are easy to overlook, but its 3- to 8-foot-tall branched
spikes of showy white flowers, each floret a tuft of stamens
surrounding a central pistil, are unmistakable. Flowering begins in
May in the south and continues into September in more northerly
regions. First described by botanists in 1705, black cohosh was
growing in English gardens by 1732.

The genus Cimicifuga includes fifteen species, of which one is
native to Europe, six to North America, and the remainder to
northeastern Asia. Collectively, they are known as bugbanes in
reference to the offensive smell of the foliage of two species, the
European C. europaea and the Asian C. foetida. (The name Cimicifuga
comes from the Latin cimex, “bug”—Cimex is also the genus of
bedbugs—and fugare, “to drive away”.) The leaves of both species,
which are also called bugworts, have been used as insect repellents
throughout their extensive ranges from India to Western Europe to
eastern Siberia. Although black cohosh leaves don’t have a strong
odor, the flowers have a unpleasant smell that somehow is designed
to attract insect pollinators. First described by botanists in 1705, black cohosh was
­growing in English gardens by 1732.

Early medicinal uses

Native American groups including the Delaware, Iroquois, and
Cherokee used the black cohosh root variously as a tonic, diuretic,
and remedy for women’s reproductive disorders and rheumatism long
before Europeans landed on American shores. Early white settlers
used it widely to treat menstrual irregularities and ­facilitate
childbirth. Nineteenth-century American physicians esteemed the
root as an anti-inflammatory for arthritis and rheumatism, for
regulating the menstrual cycle, treating nervous disorders, and
relieving pain following childbirth, and it was an official drug in
the U.S. Pharmacopoeia from 1820 to 1926. Eclectic physicians in
particular championed the use of black cohosh. John King
(1813–1893), a professor of obstetrics at the Eclectic medical
college in Cincinnati, Ohio, called it his favorite remedy for
“abnormal conditions of the principal organs of reproduction in the
female”.

Modern use

Most of the scientific research on black cohosh during the past
century has taken place in Germany, where the herb is today widely
used to treat menopausal complaints. Over the years, chemists have
isolated various compounds from the roots, including phytosterin,
isoferulic acid, salicylic acid, sugars, tannins, and fatty acids,
as well as several glycosides and an isoflavone. Although no single
constituent has been pinpointed as accounting for the root’s
biological activity, researchers believe that a number of compounds
may act synergistically to produce their effects.

A 1944 study on mice first attributed estrogenic activity to the
root. By the mid-1960s, sufficient laboratory and clinical evidence
had been amassed to support the widespread use of black cohosh by
German gynecologists as an alternative for conventional hormone
replacement therapies, which had shown undesirable side effects.
Some fourteen studies on a total of about 1,500 women done over
more than forty years supported the root’s effectiveness in
reducing the severity and duration of hot flashes as well as
depressive moods associated with meno­pause.

With the decline in ovarian function and estrogen production at
menopause, the production of luteinizing hormone by the pituitary
gland increases, a change that has been associated with hot
flashes. A 1985 German study found that black cohosh significantly
reduced serum concentrations of luteinizing hormone in rats that
had undergone surgical menopause (removal of their ovaries). A 1991
clinical study of 110 menopausal women confirmed these
findings. Although no single ­constituent has been pinpointed as
­accounting for the root’s biological activity, researchers believe
that a number of compounds may act synergistically to produce their
effects.

Other studies showed that black cohosh relieves meno­pausal
symptoms in addition to hot flashes. In a 1982 multicenter German
study of 629 meno­pausal women who received 4 mg of a black cohosh
extract twice daily for six to eight weeks, 49 percent of the
participants reported a dramatic reduction in hot flashes,
sweating, headaches, vertigo, palpitations, and tinnitus attributed
to menopause. More than 39 percent also noted a decrease in
nervousness, irritability, and depression. Seven percent reported
minor gastrointestinal distress.

In a 1987 German double-blind study, thirty women received 8 mg
of a black cohosh ­extract each day, thirty received conventional
estrogen replacement therapy, and twenty received a placebo for
three months. The black cohosh preparation was well tolerated and
produced significant improvements in menopausal symptoms compared
to the placebo. Black cohosh also outperformed the estrogen
therapy, but the estrogen dose was so low as to make this finding
inconclusive.

A 1988 German comparison over twenty-four weeks of three
different estrogen therapies and an extract of black cohosh in
fifty-three women with menopausal symptoms found the black cohosh
extract to be comparable to treatment with the three conventional
drugs. The researchers concluded that in cases in which
conventional hormone therapy is contraindicated, the plant extract
is the therapy of choice.

Taking black cohosh

Used in Europe by more than 1.5 million women during the past
forty years, black cohosh is again becoming known in its native
land as a viable treatment for reducing unpleasant symptoms
associated with menopause. In the United States, black cohosh is
sold in health-food stores as a dietary supplement. The German
Commission E allows black cohosh products to be labeled for
premenstrual symptoms, painful or difficult menstruation, and
menopausal symptoms such as hot flashes. The daily dose of a liquid
extract with 40 to 60 percent alcohol is equivalent to 40 mg of the
dried root. Most studies have used 8 mg daily of a concentrated
extract. Upset stomach is the only side effect reported. Because
long-term toxicity studies have not been conducted, recommended use
is limited to no longer than six months.

Boxwood Battles HIV

Boxwood (Buxus sempervirens) is a classic evergreen hedge plant,
long grown in formal herb gardens for its ease of shaping. It’s
also a medicinal herb. A recent French study, prompted by earlier
reports of boxwood’s antiviral activity, suggests that the herb
shows potential against the human immune deficiency virus
(HIV).

The randomized, double-blind, multicenter trial involved 145
HIV-positive but symptomless people who had not previously been
treated for HIV. For thirty-eight weeks, 48 received 990 mg per day
of a boxwood extract, 49 received 1980 mg per day, and 48 received
a placebo. Researchers tracked immune-cell counts and other
measures relating to the progression of HIV infection to full-blown
AIDS. Of the 120 participants who completed the study, those who
received 990 mg of boxwood per day exhibited significantly delayed
progression of HIV compared with persons receiving either 1980 mg
or the placebo. No severe side effects were reported in any group.
Further trials will certainly follow to determine the most
effective dosage: boxwood contains toxic alkaloids that in excess
can cause bloody diarrhea, convulsions, and respiratory failure.
Sheep, horses, pigs, and cattle have died from eating the leaves or
leaf clippings.(1)

Turmeric for Ulcers?

The rhizomes of turmeric (Curcuma longa), a tropical member of
the ginger family, are as ubiquitous in Vietnamese markets as
garlic and carrots are in the United States. It is widely used as a
folk medicine for numerous disorders, including duodenal ulcer, a
lesion in the wall of that segment of the small intestine lying
just beyond the stomach.

A recent joint Vietnamese-Swedish study assessed the
effectiveness of a daily dose of 6 g of ground turmeric rhizome
versus a placebo in treating duodenal ulcer. Each of the 188
participants (94 in each group) had a single duodenal ulcer at
least 5 mm wide and had not received any conventional ulcer drugs
before joining the study. All participants showed symptomatic
relief after the first week, and symptoms decreased further in both
groups during the eight-week trial. Although those who took the turmeric showed slightly greater
improvement, the difference between groups was not statistically
significant, meaning that turmeric is no better than a placebo in
the treatment of duodenal ulcer.(2)

Remember Ginkgo

Add a new rat study to the growing evidence of Ginkgo biloba’s
ability to improve memory. A 1997 study showing that ginkgo could
delay the progress of Alzheimer’s disease published in the Journal
of the American Medical Association sparked a media frenzy over the
popular herb and encouraged additional research into ginkgo’s
potential use in people with early-stage Alzheimer’s disease.

The six-month rat study, conducted by the Department of
Pharmacology and Toxicology at the School of Medicine and
Biomedical Sciences, State University of New York at Buffalo,
evaluated the effects of varying doses of a ginkgo-leaf extract on
cognitive behavior in ten male rats as compared to twenty male rats
that received a placebo. The rats were placed in a maze and run
through tests designed to assess memory. Researchers found a statistically significant correlation
between the increase in ginkgo dosage and the decrease in the
number of errors made by the rats during testing. Unexpectedly, the
rats that consumed the ginkgo also lived longer than those in the
placebo group.(3)

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